Individual provider Active NPI

Kelley Cox Rodriguez, RN

  • Certified Registered Nurse Anesthetist
  • Rocky Mount, NC
National Provider Identifier
1801412176
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
128420 Issued in NC
Practice address
2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone
(252) 962-8000
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 239133 NC
Certified Registered Nurse Anesthetist 367500000X 128420 NC Primary

Addresses

Primary practice location

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237

Mailing address

1070 E 5TH St
Roanoke Rapids, NC 27870-2234
Phone (252) 532-4462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201013001445 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668892654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nash Hospitals IncGroup PAC ID 4284521568, 39 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone (252) 962-8000

250 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone (252) 535-8240

Hospital & facility affiliations

  • Ecu Health North Hospital Hospital, Roanoke Rapids, NC, CCN 340151
  • Unc Health Nash Hospital, Rocky Mount, NC, CCN 340147

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
128420NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nash Hospitals Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Nash Hospitals Inc CurrentSince Oct 1, 2020 Accepting new patients
Vidant Medical Group LLC CurrentSince Jul 17, 2023 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1801412176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 E 5TH ST",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278702234",
            "telephone_number": "252-532-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 CURTIS ELLIS DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042237",
            "telephone_number": "252-962-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KELLEY",
        "middle_name": "COX",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "239133",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "128420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.